Provider First Line Business Practice Location Address:
PM&R B403, UNIVERSITY HOSPITAL, 150 BERGEN STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEWARK
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07103-2425
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
973-972-7188
Provider Business Practice Location Address Fax Number:
973-972-5725
Provider Enumeration Date:
05/03/2007